Readiness for hospital discharge in adult cancer patients and its association with burden, anxiety, and fear among informal caregivers during the hospital-to-home transition: a scoping review. / Readiness for hospital discharge nei pazienti oncologic

Background: The transition from hospital to home is a critical phase in the cancer care continuum. Following discharge, patients and their informal caregivers are often required to manage complex clinical, psychological, and practical care needs, including symptom monitoring, medication management, treatment-related adverse effects, coordination of healthcare services, and communication with healthcare professionals. Inadequate preparedness for discharge may negatively affect both patient outcomes and caregiver well-being. Readiness for Hospital Discharge (RHD) refers to the extent to which patients perceive themselves as prepared to leave the hospital and manage their care after discharge. This concept encompasses multiple dimensions, including physical status, knowledge, coping ability, and expected support. In oncology settings, discharge readiness may be particularly relevant due to the complexity of cancer care, the increasing shift toward outpatient and home-based management, and the substantial involvement of informal caregivers. Informal caregivers play a central role in supporting patients during the transition from hospital to home. However, caregiving responsibilities may be associated with psychological and emotional challenges, including caregiver burden, anxiety, fear, uncertainty, and distress. These outcomes may be influenced by the patient's level of discharge readiness, the complexity of care required at home, the quality of discharge planning, and the availability of healthcare and social support services. Purpose: The purpose of this scoping review is to systematically map and synthesize the available evidence regarding readiness for hospital discharge among adult oncology patients and its association with caregiver burden, anxiety, fear, and related psychosocial outcomes during the hospital-to-home transition. The review will also explore the influence of patient clinical and care complexity, discharge planning processes, transitional care interventions, and palliative care involvement on discharge readiness and caregiver outcomes. Research Question: What evidence is available regarding readiness for hospital discharge among adult oncology patients and its association with burden, anxiety, and fear among informal caregivers during the transition from hospital to home? Methods: The review will follow the Joanna Briggs Institute (JBI) methodology for scoping reviews and will be reported according to PRISMA-ScR guidelines. Quantitative, qualitative, and mixed-methods studies conducted in oncology and palliative care settings will be considered for inclusion. A comprehensive search strategy will be employed to identify relevant studies, followed by systematic screening, data extraction, and evidence mapping. This review is expected to: - map the extent, characteristics, and distribution of the available evidence; - identify how readiness for hospital discharge is conceptualized and measured in oncology settings; - describe caregiver burden, anxiety, fear, and related psychosocial outcomes associated with hospital discharge; - identify factors influencing discharge readiness, including patient clinical complexity and care needs; - examine the role of discharge planning, transitional care interventions, and palliative care services; - identify gaps in the current literature and priorities for future research. Finally, the findings may contribute to the development of patient- and family-centered discharge planning strategies, support the design of transitional care interventions, and inform clinical practice and future research aimed to improving discharge experiences and caregiver well-being in oncology and palliative care settings.